Culture rules at Delta Dental. It's key to our becoming the leading dental benefits carrier in the state, reaching over 500,000 Idahoans with our dental plans and community outreach programs. We're small on ego and big on grins. You'll see us involved in community events and "Did you make someone smile today?" on our To-Do lists. Our employees have the opportunity to make a difference in people's lives while working in an environment full of challenge, collaboration, flexibility, and industry-leading growth potential. Join our team committed to better oral health for all Idahoans. The Customer Service Specialist is responsible for customer service interactions with providers, subscribers, other carriers, and internal customers regarding benefit clarifications, claim status and resolution, and general product and service questions. Essential Functions Respond to stakeholder inquiries via phone or written correspondence, accessing reference materials as needed to analyze and determine appropriate response. Prepare or process claims and adjustments in an accurate and timely manner. Prepare inbound appeals for review. Recommend and actively participate in implementing improvements in workflow and processing. May perform backup functions in the following areas after additional training: Plan set up; Provider Database Maintenance; processing Orthodontia claims, and others as needed. May serve as liaison for JIRA tickets for Dental Services team May be assigned to a specialty team depending upon skillset. Demonstrate a commitment to the organization's vision, mission, values, code of ethics, and compliance/security standards. Other duties as assigned Requirements KNOWLEDGE, SKILLS, AND ABILITIES A minimum of 2 years of experience as a Dental Assistant; Dental Hygienist; or front Dental Office staff is required. A minimum of 1 year of experience in customer service. Knowledge of dental terminology Competency in Microsoft Office - Word, Excel, and Outlook Excellent oral and written communication skills and the ability to interact with internal and external stakeholders in an effective and positive manner. Ability to function with high levels of call volume and workload. Ability to understand individual group benefits and master contract provisions. Strong skills, abilities, and commitment to teamwork, customer service, and dependability. Attention to detail. PHYSICAL AND MENTAL REQUIREMENTS Sitting/Standing (alternatively) continuously Keyboard Use/Repetitive Hand motion continuously Skill/ability related to comprehension, organization, reasoning/decision-making and communication appropriate to position/level
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